ATTITUDE

AND PERSONALITY ASPECTS

IN MEDICAL EDUCATION

Sylvia D. Elvira
Department of Psychiatry
Faculty of Medicine - University of Indonesia
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Introduction

If you are a patient, what would

you expect of the doctors
attitude
and
behavior?

That is how you should

envision yourself in being a
doctor!

People expect you to conduct

your professional duty
compassionately.
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Introduction (2)

That implies aspects of attitude:

i.e. sincere, with honesty,
empathetic, professional, etc.

Introduction

Because we are dealing with personal

privacy, confidentiality, trust, ethics and
legal aspects,
it became so important
in medical practice.
Doctor-patients relationship
become the central issue
in medical practice.

Introduction

More than just having

the skill in diagnosis and
treatment of diseases,
medical doctors
should have the ability for
considerate
interpersonal communication.

Introduction

It should took into account,

the sacred mission in
its objectives.
It differs from
other professions in
that deals with
delicate personal matters.

Attitude, behavior & personality

Attitude :
manner of carrying oneself;
disposition (stood in a graceful attitude);
- a state of mind or feeling (hostile attitude)
a functional
expression of behavior.

Attitude, behavior & personality

Behavior
the specified way to
conduct oneself, to perform
the actions or reactions of
a person in response to external
or internal stimuli.

Behavior is a more general term conduct

applies to actions considered from the
standpoint of morality and ethics.

Attitude, behavior & personalty (2)

Behavior is a functional manifestation of personality a reflection of personality.

Personality the totality of qualities and traits,
collective character, behavioral, emotional, and
mental traits, distinctive to a person.
Developed throughout life, and more or less took its
stable form during adolescence.
Talking about attitude formation is in essence talking
about the whole process of personality development.

Doctor-Patients Relationship

Keywords: Acceptance - Empathy - Rapport

Acceptance: unpretentious acceptance.
Empathy: the ability to comprehend and feel
(empathize), not just cognitive understanding, but
inclusive the affective quality as part of the
interpersonal relation/communication.
Rapport: an established empathic interpersonal
relationship, with the sense of trust and
understanding. An established meaningful
humane quality of communication.
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Doctor-Patients Relationship
(2)

How could we attained such qualification?

In fact, not all MDs could perform such

qualification in interpersonal/doctor-patient
relationship
It is not just a matter of intellectual /
academic performance.

It depends much on the basic personality,

developmental and cultural background.

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Doctor-Patients Relationship

Doctor-patient relationship
is based on a sustained,
open, and
trusted dialog
as well as on the sharing of
information and knowledge
(Roter, 2000).

Doctor-Patients Relationship

Health care has seemingly shifted from

placing the patient as a whole person at
the center of a therapeutic relationship to
looking almost exclusively at the
biological (i.e., molecular, chemical, and
physical) nature of the patient.
This change in focus has concerned many
patients and health-care providers

Doctor-Patients Relationship

A more current viewpoint incorporates

the patients perspective and includes
the patient as a collaborative
partner
with his/her
doctor
(Roter, 2000; Murphy et al., 2001).

This collaboration is essential to

a high-quality doctor-patient relationship,
which leads to quality
health care and
positive
outcomes

Human Behavior

Hippocrates wrote:
"It is more important to
know
what sort of
person has a disease
than to know what sort of disease
a person has

To understand attitude and personality, we should

understand the essential part of human behavior.
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Human Behavior

Unlike the more primitive species, human

behavior is a learned behavior (not much of an
instinctual behavior).

Human instinct - as the basic driving power

Biological constitution, psycho-educational

process and socio-environmental experiences
(bio-psycho-social) constitute the basis for
personality development.

Attitude/Behavior
and Personality Change

Personality is a unique individual traits which

reaches its stable form after adolescence.

Attitude/behavior is the reflection of

personality.

Some of the personality traits/profiles were

very rigid and difficult to change or modified .
Such as: the obsessive-compulsive personality, antisocial
personality, schizoid personality, etc.
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Attitude/Behavior
and Personality Change

Every profession
with high responsibility
required to be supported
by those with
conducive aspects of
personality pattern.

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Attitude/Behavior
and Personality Change

The same principle

applied to Medical profession.
Not all personality pattern
is suitable for
medical profession.

Attitude/Behavior
and Personality Change

Personality is
the basic ground for
behavioral manifestations
and professional conducts.

Attitude/Behavior
and Personality Change
Possibility of behavioral/personality change:
If the person is well motivated
& sustained by a
favorable environment
(unfortunately it is not
always on
the positive direction).

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Possibility of behavioral/personality
change:

Backed up by a
conducive personality pattern.
Behavior and attitude
are more susceptible for change.
Long enough to sustain
a meaningful
lasting behavioral change

Attitude/Behavior
and Personality Change

Attitude formation is not as simple as building

personal characters by giving advise or lecture it
is a complex years of developmental learning
process involving various factors.
Attitude and behavior are the observable
manifestations of personality aspects in social
communication in normal as well as illness.
Some conditions might need special behavior
modification techniques to change.
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Attitude

Is a part of the behavioral manifestations:

manner of carrying oneself in relation to others the way to talk and express oneself, a position of
the body, a state of mind or feeling, disposition.

Attitude formation might be an artificial and

temporary one, but if compatible, it may also
serve the personality or behavioral disposition in a
more predictable pattern. People could learn a
genuine way of communication, an artificial or
symbolic way.
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Attitude

With regard to the objectives of medical

education, assessment of the personality
and behavior of medical students are
more meaningful than assessment of the
attitudes.

Observation of attitudes may serve as

indicator for monitoring qualification.

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Attitude
Various behavioral aspects relevant to
medical profession:

Moral
Ethics
Social norms and values

Other aspect to be considered:

Legal aspect / consequences

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Moral, Ethics, Norms & Values

Attitude/behavioral guidance towards a more

organized and civilized community-life.
Assumed to aspire good reasons for a better
social-life. Unfortunately there are no infallible
standard measures.
Everything will revert to conscience
- a subjective judgmental conjunction with respects
to humanitarian consideration.
Refer back to the baseline: personality, behavior
and attitude.
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Moral. Ethics, Norms & Values

(2)

Moral: the quality of behavior or attitudes as

seen from the judgmental presumption, based on
social conformity of good & bad standards. It
depends much on the individual insight.

Ethics: the philosophical revelation of moral in

terms of rules or standards governing the conduct
of members of a specific group or profession.

Ethic: a set of principles of right conduct*)

*) American Heritage College Dictionary
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Moral. Ethics, Norms & Values

(3)

Social Norms & Values:

an unwritten set of standards for behavioral
conduct, built up as part of social or cultural way of
life
the measuring codes of
conduct in a particular social environment.
Developed alongside history of the society by the
influence of traditional, cultural and religious values.

Codes or aphorism?
In a chaotic community, these norms & values
became futile. Inconsistency, inconsequence and
double standards, became the guiding principles.
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Significant Issues
Relevant to Medical Education

Students perspectives:

personal/potential compatibility (cognitive/

affective, personality profile, etc.)
adjustment capability related to cultural and
educational background (coping mechanism)
inherent adjustment problems attributed to
philosophical/ historical background
degree of insight in personality function and
development.
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Significant Issues
Relevant to Medical Education (2)

Institutional perspectives:
Enrollment screening requirements
Clarity, efficiency, consistency and
consequence in the institutional rules
Clarity in educational objectives
Institutional environment / identification figure
Availability of guidance & counseling service
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CLOSING REMARKS

Conducive personality and behavior are essential

assets for medical students and/or medical doctors.
Its significance precedes attitude formation.
Even though its difficult to assess (except on its
extreme manifestations), it should be part of
qualification assessment.
Complex developmental background (bio-psychosocial) should be considered in the assessment.
Medical students should be knowledgeable about
personality and its developmental process.
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CLOSING REMARKS (2)

Attitudes could be directed to a certain pattern
through learning process, exercise, experiences,
and other behavioral approach.
Change in attitude does not assure a long-lasting
behavioral & personality change. Subject to
individual variation rooted in the basic personality.
Needs enduring insight and strong motivation for
behavioral & personality change.
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CLOSING REMARKS (3)

Try to be open minded and understanding in self
assessment and criticism. Be receptive for possibility
of positive personality development.
Some personality traits are not amenable to
behavioral change, and in fact are not conducive for
medical education.
Moral, ethics, social norms & values, legal aspects,
etc., are only guidelines. The more important
individual controlling power is the conscience.
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Supernatural
Religiousness/
Spiritualism
Organo-Biologic

Nature &
environment

Psycho-educative

What medical science

Learned as Scientific Base
is indeed only a small part of
the BIO-PSYCHO-SOCIAL aspects
Of the whole nature

Social environment,
& culture (including
beliefs, religion)
Sasanto Wibisono, 1992
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Thank you
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